NICE Recommends Tests to Help Target Treatments for Non-Small-Cell Lung Cancer
The UK's National Institute for Health and Care Excellence (NICE) has issued guidance recommending a number of tests and test strategies to help more effectively target the treatment of non-small-cell lung cancer (NSCLC), which accounts for around 72% of all lung cancer cases in England and Wales.
The outcome of patients with this type of cancer can be improved if it can be determined that their tumor has a particular genetic mutation that can produce an enzyme [epidermal growth factor receptor-tyrosine kinase (EGFR-TK)] which accelerates the growth of the cancer cells. If this is the case, chemotherapy treatment can include a drug that inhibits the action of the EGFR-TK mutation.
After evaluating the available tests and test strategies for EGFR-TK mutation testing in adults with previously untreated, locally advanced or metastatic, NICE recommends the following:
- therascreen EGFR RGQ PCR Kit (CE-marked, Qiagen)
- cobas EGFR Mutation Test (CE-marked, Roche Molecular Systems)
- Sanger sequencing of samples with more than 30% tumour cells and therascreen EGFR RGQ PCR Kit for samples with lower tumour cell contents
- Sanger sequencing of samples with more than 30% tumour cells and cobas EGFR Mutation Test for samples with lower tumour cell contents
- Sanger sequencing followed by fragment length analysis and polymerase chain reaction (PCR) of negative samples
NICE concluded that there was insufficient evidence for any recommendations on five otherEGFR-TK mutation tests: high-resolution melt analysis; pyrosequencing combined with fragment length analysis; single-strand conformation polymorphism analysis; next-generation sequencing; and the therascreen EGFR Pyro Kit (CE-marked, Qiagen).